超声引导下精索阻滞麻醉对阴囊急诊手术患者应激反应和并发症的影响

Effects of Ultrasound-guided Spermatic Cord Block Anesthesia on Stress Response and Complications in Patients Undergoing Scrotal Emergency Surgery

目的:探究超声引导下精索阻滞麻醉对阴囊急诊手术患者应激反应和并发症的影响。方法:选择2020年10月至2022年12月来我院行阴囊急诊手术的急诊患者60例,按照随机数表法,分为观察组(n=30)和对照组(n=30)。两组均行精索阻滞麻醉,其中对照组采用盲探穿刺法,观察组采用超声引导的方式。比较两组患者阻滞成功率、麻醉方式更改人数、麻醉药物追加人数及并发症发生人数,比较不同时间点两组的疼痛(VAS)评分,比较术前及术后两组的应激反应[皮质醇(Cor)]、抗氧化指标[超氧化物歧化酶(SOD)]、炎性因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平。结果:观察组患者阻滞成功率为90.00%,高于对照组的66.67%(P<0.05),观察组麻醉方式更改率为6.67%低于对照组的9例30.33%(P<0.05),两组麻醉药物追加人数比较,差异无统计学意义(P>0.05);手术开始5 min及术后4、8、12 h时,观察组患者的VAS评分均低于对照组的(P<0.05);两组患者术后24 h时的Cor、IL-6、IL-8水平均高于术前,但是观察组为低于对照组(P<0.05),两组术后24 h的SOD均低于术前,而观察组为高于对照组(P<0.05);观察组的血肿、刺破血管发生率分别为6.67%、10.00%,均低于对照组的30.00%、36.67%(P<0.05)。结论:精索阻滞麻醉对阴囊急诊手术患者具有较好的阻滞效果,能够为患者带来更好的镇痛效果,降低术后应激及炎症反应。

Objective:To explore the effects of ultrasound-guided spermatic cord block anesthesia on stress response and complications in patients undergoing scrotal emergency surgery.Methods:A total of 60 patients undergoing scrotal emergency surgery in the hospital were enrolled between October 2020 and December 2022.According to random number table method,they were divided into observation group(n=30)and control group(n=30).The control group was given blind-probing puncture,while observation group was given ultrasound guidance.The success rate of block,number of cases with anesthesia modes change,additional anesthesia drugs and complications,scores of Visual Analogue Scale(VAS)at different time points,levels of stress response index[cortisol(Cor)],antioxidant index[superoxide dismutase(SOD)]and inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8)]before and after surgery were compared between the two groups.Results:The success rate of block in observation group was higher than that in control group(90.00%vs 66.67%,P<0.05),and change rate of anesthesia modes was lower than that in control group(6.67%vs 30.33%,P<0.05).There was no significant difference in the number of cases with additional anesthesia drugs between the two groups(P>0.05).At 5 min after the start of surgery,4 h,8 h and 12 h after surgery,VAS scores in observation group were lower than those in control group(P<0.05).At 24h after surgery,Cor,IL-6 and IL-8 in both groups were increased,which were lower in observation group than control group(P<0.05),while SOD was decreased,which was higher in observation group than control group(P<0.05).The incidence rates of hematoma and punctured blood vessel in observation group were 6.67%and 10.00%,lower than those in control group(30.00%,36.67%,P<0.05).Conclusion:Spermatic cord block anesthesia has good block effect in patients undergoing scrotal emergency surgery,which can bring better analgesic effect and reduce postoperative stress and inflammation response.